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Cited by 348Inflammatory Bowel DiseaseTryptophan and brain disordersOcular Diseases and Behçet’s Syndrome

Symptoms of depression and anxiety are independently associated with clinical recurrence of inflammatory bowel disease

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Mikocka-Walus, Antonina, Pittet, Valerie, Rossel, Jean-Benoît, von Känel, Roland, Anderegg, Claudia, Bauerfeind, Peter, Beglinger, Christoph, Begré, Stefan +159 more·2016·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2015.12.045
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Abstract

Background & aims We examined the relationship between symptoms of depression and anxiety and clinical recurrence of inflammatory bowel disease (IBD) in a large patient cohort. We considered the progression of depression and anxiety over time.Methods We collected clinical and treatment data on 2007 adult participants of the Swiss IBD study (56% with Crohn's disease [CD], 48% male) performed in Switzerland from 2006 through 2015. Depression and anxiety symptoms were quantified by using the Hospital Anxiety and Depression Scale. The relationship between depression and anxiety scores and clinical recurrence was analyzed by using survival-time techniques.Results We found a significant association between symptoms of depression and clinical recurrence over time (for all patients with IBD, P = .000001; for subjects with CD, P = .0007; for subjects with ulcerative colitis, P = .005). There was also a significant relationship between symptoms of anxiety and clinical recurrence over time in all subjects with IBD (P = .0014) and in subjects with CD (P = .031) but not ulcerative colitis (P = .066).Conclusions In an analysis of a large cohort of subjects with IBD, we found a significant association between symptoms of depression or anxiety and clinical recurrence. Patients with IBD should therefore be screened for clinically relevant levels of depression and anxiety and referred to psychologists or psychiatrists for further evaluation and treatment.

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  • Episodes of anxiety and depression have a significant impact on IBD disease outcomes, including IBD flares.

    “these episodes of anxiety and depression then have a significant impact on IBD disease outcomes, including IBD flares,40”

    From Acceptance commitment therapy (ACT) for psychological distress associated with inflammatory bowel disease (IBD): protocol for a feasibility trial of the ACTforIBD programme (2022) · cites this paper as [40]

    The Results section reports significant associations between depression and clinical recurrence, and between anxiety and recurrence in the overall IBD cohort; it also reports associations with some flares. But the Introduction says no causal link has been established, so “have a significant impact” overstates the evidence. Anxiety was not significantly associated with clinical recurrence in the UC subgroup. (LLM, conf=0.88)

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  • Comorbid psychological difficulties in IBD are associated with disease activity, flares, treatment response, and the necessity of surgical intervention.

    “Indeed, comorbid psychological difficulties are associated with disease activity, flares, treatment response, and the necessity of surgical intervention [2,6,8,9,10,11,12,13,14,15].”

    From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [12]

    The Results section (page unavailable) links depression or anxiety symptoms with flares, and depression with surgery in Crohn’s disease; the paper also examines disease activity. It reports associations with steroid or biologic use, but does not establish an association with treatment response. The surgery finding is specific to depression in Crohn’s disease, rather than psychological difficulties across all IBD. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The 13 eligible articles reported on 12 separate study populations containing 9192 patients.

    “The 13 eligible articles reported on 12 separate study populations,[11, 20-30, 33] containing 9192 patients.”

    From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [28]

  • Among three studies recruiting 2844 patients, risk of a composite endpoint of one or more adverse outcomes was significantly higher among those with symptoms of anxiety at baseline (RR = 1.21; 95% CI 1.08-1.36), with low heterogeneity (I2 = 19.8%).

    “Finally, among three studies that recruited 2844 patients,[26, 28, 30] and which reported a composite endpoint of one or more of these adverse outcomes, risk was significantly higher among those with symptoms of anxiety at baseline (RR = 1.21; 95% CI 1.08-1.36), with low heterogeneity ( I 2 =19.8%)”

    From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [28]

  • Original investigators were contacted and additional data were obtained from six studies to maximise the number of eligible studies for analysis.

    “We also contacted original investigators and obtained additional data from six studies,[26-30, 33] to maximise the number of eligible studies for analysis.”

    From Bidirectional brain-gut axis effects influence mood and prognosis in IBD: A systematic review and meta-analysis (2022) · cites this paper as [28]

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Authors
Mikocka-Walus, A., Pittet, V., Rossel, J.-B., von Känel, R., Anderegg, C., Bauerfeind, P., Beglinger, C., Begré, S., Belli, D., Bengoa, J. M., Biedermann, L., Bigler, B., Binek, J., Blattmann, M., Boehm, S., Borovicka, J., Braegger, C. P., Brunner, N., Bühr, P., Burnand, B., Burri, E., Buyse, S., Cremer, M., Criblez, D. H., de Saussure, P., Degen, L., Delarive, J., Doerig, C., Dora, B., Dorta, G., Egger, M., Ehmann, T., El-Wafa, A., Engelmann, M., Ezri, J., Felley, C., Fliegner, M., Fournier, N., Fraga, M., Frei, P., Frei, R., Fried, M., Froehlich, F., Funk, C., Ivano Furlano, R., Gallot-Lavallée, S., Geyer, M., Girardin, M., Golay, D., Grandinetti, T., Gysi, B., Haack, H., Haarer, J., Helbling, B., Hengstler, P., Herzog, D., Hess, C., Heyland, K., Hinterleitner, T., Hiroz, P., Hirschi, C., Hruz, P., Iwata, R., Jost, R., Juillerat, P., Kessler Brondolo, V., Knellwolf, C., Knoblauch, C., Köhler, H., Koller, R., Krieger-Grübel, C., Kullak-Ublick, G., Künzler, P., Landolt, M., Lange, R., Serge Lehmann, F., Macpherson, A., Maerten, P., Maillard, M. H., Manser, C., Manz, M., Marbet, U., Marx, G., Matter, C., McLin, V., Meier, R., Mendanova, M., Meyenberger, C., Michetti, P., Misselwitz, B., Moradpour, D., Morell, B., Mosler, P., Mottet, C., Müller, C., Müller, P., Müllhaupt, B., Münger-Beyeler, C., Musso, L., Nagy, A., Neagu, M., Nichita, C., Niess, J., Noël, N., Nydegger, A., Obialo, N., Oneta, C., Oropesa, C., Peter, U., Peternac, D., Marie Petit, L., Piccoli-Gfeller, F., Beatrice Pilz, J., Pittet, V., Raschle, N., Rentsch, R., Restellini, S., Richterich, J.-P., Rihs, S., Alain Ritz, M., Roduit, J., Rogler, D., Rogler, G., Rossel, J.-B., Sagmeister, M., Saner, G., Sauter, B., Sawatzki, M., Schäppi, M., Scharl, M., Schelling, M., Schibli, S., Schlauri, H., Schmid Uebelhart, S., Schnegg, J.-F., Schoepfer, A., Seibold, F., Seirafi, M., Semadeni, G.-M., Semela, D., Senning, A., Sidler, M., Sokollik, C., Spalinger, J., Spangenberger, H., Stadler, P., Steuerwald, M., Straumann, A., Straumann-Funk, B., Sulz, M., Thorens, J., Tiedemann, S., Tutuian, R., Vavricka, S., Viani, F., Vögtlin, J., Von Känel, R., Vonlaufen, A., Vouillamoz, D., Vulliamy, R., Wermuth, J., Werner, H., Wiesel, P., Wiest, R., Wylie, T., Zeitz, J., & Zimmermann, D.
Affiliations
Institute of Social and Preventive Medicine (CH)
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2016-06
Volume
14
Issue
6
Pages
829-835.e1
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2015.12.045
OpenAlex
W2253459515
Cited by
348
References
49
Citations by year
2026: 19 · 2025: 36 · 2024: 31 · 2023: 38 · 2022: 37 · 2021: 59 · 2020: 42 · 2019: 32 · 2018: 25 · 2017: 17 · 2016: 11
FWCI
22.89
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (acceptedVersion)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • IRIS (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Funders
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (33CS30-148422)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
Keywords
inflammatory bowel disease, depression, anxiety, clinical recurrence, Crohn's disease, ulcerative colitis, psychiatric comorbidity, Hospital Anxiety and Depression Scale, depression screening
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Depression, Female, Humans, Male, Middle Aged, Prospective Studies, Recurrence, Severity of Illness Index, Switzerland, Inflammatory Bowel Diseases, Young Adult

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